Due to nationwide shortages of some phlebotomy tubes specified for trace element testing, ARUP Laboratories is currently accepting lavender (EDTA) tubes.

Ordering Recommendation

Recommended for routine testing for lead exposure. For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016).

Mnemonic

LEAD-WB

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-3 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation
Collect

Royal blue (K2EDTA or Na2EDTA) or tan (K2EDTA).

Specimen Preparation

Transport 7 mL whole blood in the original collection tube (royal blue). (Min: 0.5 mL) OR Transport 3 mL whole blood in the original collection tube (tan). (Min: 0.5 mL)

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Unacceptable Conditions

Serum. Specimens collected in tubes other than Royal Blue (K2EDTA or Na2EDTA) or tan (K2EDTA). Heparinized or clotted specimens. Capillary pediatric EDTA collection tubes, refer to Lead, Blood (Capillary) 0020745.

Remarks

Trace Elements requisition form may be required (ARUP form #32990).

Stability

Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable

Reference Interval

Effective December 6, 2021

Age Reference Internal
0-5 years Less than or equal to 3.4 µg/dL
6 year or above Less than or equal to 4.9 µg/dL

Interpretive Data

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified lead-free tube. If contamination concerns exist due to elevated levels of blood lead, confirmation with a second specimen collected in a certified lead-free tube is recommended.

Information sources for blood lead reference intervals and interpretive comments include the CDC's "Childhood Lead Poisoning Prevention: Recommended Actions Based on Blood Lead Level" and the "Adult Blood Lead Epidemiology and Surveillance: Reference Blood Lead Levels (BLLs) for Adults in the U.S." Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.


Children
Concentration Comment
3.5-19.9 µg/dL Children under the age of 6 years are the most vulnerable to the harmful effects of lead exposure. Environmental investigation and exposure history to identify potential sources of lead. Biological and nutritional monitoring are recommended. Follow-up blood lead monitoring is recommended.
20-44.9 µg/dL Lead hazard reduction and prompt medical evaluation are recommended. Contact a Pediatric Environmental Health Specialty Unit or poison control center for guidance.
Greater than 44.9 µg/dL Critical. Immediate medical evaluation, including detailed neurological exam is recommended. Consider chelation therapy when symptoms of lead toxicity are present. Contact a Pediatric Environmental Health Specialty Unit or poison control center for assistance.

Adults
Concentration Comment
5-19.9 µg/dL Medical removal is recommended for pregnant women or those who are trying or may become pregnant. Adverse health effects are possible. Reduced lead exposure and increased blood lead monitoring are recommended.
20-69.9 µg/dL Adverse health effects are indicated. Medical removal from lead exposure is required by OSHA if blood lead level exceeds 50 µg/dL. Prompt medical evaluation is recommended.
Greater than 69.9 µg/dL Critical. Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present.

Compliance Category

Laboratory Developed Test (LDT)

Note

Hotline History

N/A

CPT Codes

83655

Components

Component Test Code* Component Chart Name LOINC
0020098 Lead, Blood (Venous) 77307-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • BLL
  • Lead (Adult)
  • Pb
  • Pb, Blood
  • Pb, Whole Blood
  • Venous blood level
Lead, Blood (Venous)